A landmark study shows that lifestyle and health factors have a greater impact on heart disease risk in women compared to men, suggesting the need for sex-specific screening approaches to more accurately assess cardiovascular risk.
Women experience a higher increase in heart disease risk from lifestyle and health factors than men, according to a recent study to be presented at the American College of Cardiology’s Annual Scientific Session (ACC.25). This groundbreaking research signals that sex-specific screening or risk assessment methods could yield more accurate cardiovascular risk evaluations and inspire heart-healthy behavior changes.
“For the same level of health, our study shows that the increase in risk [related to each factor] is higher in women than in men — it’s not one-size-fits-all,” lead author Maneesh Sud, a clinician scientist at Sunnybrook Health Sciences Centre in Toronto, said in a news release. “This is novel and something that hasn’t been seen in other studies.”
The study examined eight risk factors linked to heart disease: diet, sleep, physical activity, smoking, body mass index, blood glucose, lipids and blood pressure.
The researchers reported that while women generally exhibited better health than men, those with adverse risk factors faced a significantly higher chance of cardiovascular events.
“We found that women tend to have better health than men, but the impact on outcomes is different,” Sud added. “The combination of these factors has a bigger impact in women than it does in men.”
The researchers analyzed data from over 175,000 Canadian adults enrolled in the Ontario Health Study between 2009 and 2017. Participants’ health was classified as ideal, intermediate or poor based on the eight risk factors.
During a median follow-up period of just over 11 years, the study tracked the incidence of seven heart disease outcomes, including heart attack, stroke and cardiovascular death.
Significant gender differences emerged: 9.1% of women were categorized as having ideal health compared to 4.8% of men, and women were less likely to fall into the poor health category.
However, the study revealed that women with poor health had nearly five times the risk of heart disease compared to women with ideal health. In contrast, men with poor health had 2.5 times the risk compared to those with ideal health.
The results suggest that existing heart disease risk models might need adjustment to more accurately reflect sex-specific risks. Further research is planned to understand the biological and sociocultural factors affecting these outcomes and to evaluate the differences among various racial and ethnic groups and women before and after menopause.
Sud will present the study, “Sex Differences in Cardiovascular Health Status and Long-Term Outcomes in a Primary Prevention Cohort,” at ACC.25 in Chicago on March 29, 2025.
Source: American College of Cardiology